Back in June I made the decision to persue Weight Loss Surgery. I caled my doctor and got the ball rolling. I contacted my insurance company and found I am required to do a 6 month doctor supervised weight loss program. Which I have been doing. I have had my psych eval and although I think the doc that did it was an idiot, I "passed". I was hoping to have surgery before the end of 2012. Then in October my husband was diagnosed with prostate cancer and wil be having his prostae removed on December 21. SOOOOOO...We had to plan for a diffeent surgery date. After looking at our schedules, we dicided to shoot for sometime late February.

I was SO SURE this was my best option. I had an out and out battle with my mother over this, and although she is still not in favor of it, we have agreed to disagree. My husband was so supportive, so was my daughter.

But now here I am, to date I have lost 70 pounds. I have less than 100 pounds to lose to reach my goal (allbeit not much less than 100, but still it is under 100.) I am beginning to wonder if I "need" surgery, if it is the right choice for me. I know no one can make that decision for me, but would love some input for those of you have been there.

A bit of past history....I have lost significant amounts of weight (65 pounds or more) in the past, only to gain them back plus more. One of te reason I originally considered surgery is because I felt it gave me the best chance of keeping the weight off.

One common demoninator in my gaining my weight back...Each time I began to gain it was due to some sort of family emergency (usually medical) that required repeated doctor or counselor visits. this wold lead to lack of meal planning and trips to a fast food joint because I was too dang tired to cook and too dang stressed to give a rats patoot! So far, I have dealth with hubby's cancer diagnosis and trips to ER and ICU from complications without giving up or failing to plan.

I have found the way I am eating now I have little to no cravings, I have become more intune with my body and know if I am REALLY hungry or just THINK I am hungry.

I am starting to wonder if surgery is "too drastic" for me at this point. Or if I am thinking it is too drastic because I am getting scared. Scared of surgery, doctors, hosptials, physical pain, lifestyle changes, etc.

IF I choose not to have surgery I plan t keep on with the doctor supervised diet plan until I am at my goal weight, and then for another year after so I have a supervised maintainence plan too.

Which leave another question, IF I choose not to have surgery and I continue seeing my doctor monthly, and I decide later that surgery is for me, does anyone know if I have start the whole 6 month thing over? If I keep going every month.

One thing the surgery does best is prevent you to gain back. Jojo! Life will be happening all the time. Only you know if you have really changed your life style and if you are able to live like that forever. Because once you get back on your past path the weight will be back.

Kate - you've done a great job losing weight. and believe me, there is no RIGHT answer here.

As you said, the hardest part is keeping it off. and you know that you're not alone in having lost and gained huge amounts of weight. As for the question of whether your insurance company will require the 6 month supervision AGAIN is one that only they can answer. And you'd better hope that you have the same insurance if you decide in a couple of years to go down the surgery road - if you're with a different company, I doubt you'll be able to get out of it [although, one never knows what their policies will actually be].

having said that, I have a thought. You said that you tend to gain when there's a family emergency, but even though that's exactly what you're going through right now, you're doing OK. what about trying to MAINTAIN [not lose] during this time period? you can go back to the plan [and congrats for finding one that's working for you!] in a few weeks [you decide the schedule] so you'll actually be CONTROLLING the situation. always a good thing.

bottom line, you don't have to make a decision right now. and keep your mother out of it! and pretty much keep your husband out of it too

Surgery might not be the right thing for right now, and that's fine. you haven't closed the door on it for later. and if anyone thinks that you've chickened out or that they've managed to 'convince' you that it was a bad idea, you have my permission to tell them to, ummmm .... buzz off [yes. that's it - the polite way to say it! ]

__________________Start your day with a smile, and get it over with.Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

Wow, Kate, congrats on losing those 70lbs.! I think jiffypop answered you best, and I'm mainly here to just congratulate you for losing that much weight without surgery. As far as weight loss surgery being a way to keep it off.... I don't have first hand experience on that.. I mean, I've gotten lipo a couple of times and that obviously didn't help me, but my sister and a few other relatives did get gastric bypass and I can tell you ALL of them have regained. My sister in particular is pretty much back to her all time highest weight; she got the surgery back in '01. None of them changed their habits. They all thought the surgery would be their cure all. The worst part is, my sister in particular had some complications post-op and when she lost the weight initially (she went from 440 to 250 in a little over a year) she had to get follow up surgeries to remove excess skin and tuck and lift body parts which entailed more healing time. Not once during all of this did she eat right or exercise. She used the excuse of convalescing for not moving around. So here she is now, 11 years later with surgical scars everywhere, a stapled stomach, and missing some intestine, and all for naught. On the other hand, one of my good friends had gastric bypass and it's been two years for her and she's doing remarkably. I guess it all depends on the person and how much they're willing to commit to the lifestyle change. You're doing great so far, and not getting the procedure done now doesn't mean you don't have to ever get it, but if I could do it without getting cut up and scarred, I would. I just wanted to point out that WLS doesn't mean it'll never come back. It came back pretty easily for my relatives (again, though, they did absolutely nothing to maintain their losses). If you're having reservations, just sit on it for a while. Keep doing what you're doing and you can always revisit the option later. I've got a few surgical scars myself (various cosmetic procedures) and I can tell you I HATE looking at them. I've tried the scar creams and whatnot, but they're still there. I'm trying to save up for laser procedures to see if that'll help hide the scars. Waking up after being cut into was not fun at all, and while I don't regret it, I'll never do it again. At the same time, this procedure is for you and you alone, and don't let anyone try to talk you out of it if this is what you want. I never even told my mom about what I had done till after I left the hospital. I knew I'd hear it from her and I didn't wanna argue with someone over what I wanted to do with my own body. But, congrats again! I can't wait for the day when I get to say I've lost 70lbs.!!

Kate, how wonderful that you have been so successful with weight loss. There are lots of maintainers on this site that have been able to keep weight gain at bay and I hope that you will become one of them.

To answer your question about requirements, I can only answer with my insurance company in mind. They required six months of continuous weight-loss supervision. Regardless of the reason, if I would have missed a check-up, I would have had to restart the process. However, they also used my starting weight and health issues to decide approval/denial. If I would have, for example, eliminated my sleep apnea (a comorbidity) prior to surgery through weight loss, they would not have then denied the procedure to me.

I miss Oprah, but her advice often rings in my head. Trust your gut. If it doesn't feel like the right decision now, then maybe it isn't.

Lakilaulea, there is so much about your response that I find insulting, that I really do not know where to start. However, I feel compelled to address these two quotes in particular:

Quote:

Originally Posted by Lakilaulea

I just wanted to point out that WLS doesn't mean it'll never come back.

While I am sure there are surgeons in the US who are not reputable, for the most part, people who chose WLS have to undergo a huge battery of exams, medical procedures, and psychological appointments prior to the surgery. Most people do not make this decision lightly and understand it is a tool to help them live their life to the fullest. I am a bit tired of the "you'll gain it all back" scare stories that people feel compelled to say. She knows this, just as she knows that she could gain back the 70lbs she has already lost.

Quote:

Originally Posted by Lakilaulea

I've got a few surgical scars myself (various cosmetic procedures) and I can tell you I HATE looking at them. I've tried the scar creams and whatnot, but they're still there. I'm trying to save up for laser procedures to see if that'll help hide the scars. Waking up after being cut into was not fun at all, and while I don't regret it, I'll never do it again.

WLS is not a vanity procedure. It is to help people who are morbidly obese live a reasonably "normal" life. I choose WLS to help stop my health from continuing to deteriorate and with hope that my constant back pain would go away. The scars, the sagging skin, the hair loss...these are superficial cosmetic issues. To try and scare someone out of WLS because they will have a few scars is truly insulting to me.

Lakilaulea, there is so much about your response that I find insulting, that I really do not know where to start. However, I feel compelled to address these two quotes in particular:

While I am sure there are surgeons in the US who are not reputable, for the most part, people who chose WLS have to undergo a huge battery of exams, medical procedures, and psychological appointments prior to the surgery. Most people do not make this decision lightly and understand it is a tool to help them live their life to the fullest. I am a bit tired of the "you'll gain it all back" scare stories that people feel compelled to say. She knows this, just as she knows that she could gain back the 70lbs she has already lost.

WLS is not a vanity procedure. It is to help people who are morbidly obese live a reasonably "normal" life. I choose WLS to help stop my health from continuing to deteriorate and with hope that my constant back pain would go away. The scars, the sagging skin, the hair loss...these are superficial cosmetic issues. To try and scare someone out of WLS because they will have a few scars is truly insulting to me.

Zeitgeist,
I have not, and would not, deter anyone from getting anything done to their own body. I know the OP knows the risks. I know the OP has discussed everything she needs to with her doctor. My saying that you can gain the weight back after WLS is not a scare tactic; it's a fact. I know you can. I've seen people do it MANY times enough to know it's possible. I'm not saying you will. I'm not saying she will. I'm saying I've seen it happen. It has nothing to do with reputable doctors. It has to do with the particular person. Making it through a battery of tests is completely different from actually living a life long change. Talking it over and making promises to yourself is different from actually implementing it. I don't know your background story just like I don't know hers. I was simply stating what I have seen happen many times to people close to me. A simple Google search will show you endless stories and facts and figures of it happening.

I know gastric bypass is not a cosmetic procedure. You don't have to tell me that. I also know that scarring to some women can really be a really unpleasant thing. I was simply pointing out something she might not have considered. I know I didn't consider it. I know my sister didn't consider it. It's so easy to not think about until you're staring at it everyday in a mirror.

All I did was share my thoughts with the OP. Who are you to try to stop me from doing that?? Where do you get off condescending me?? My response wasn't for you. It was for her. It was meant with the best intentions. It was just an opinion. I didn't say do or don't do anything in my response. I'm sorry if I insulted you, but I was not talking to you in the first place.

I felt your response was typical of those who use scare tactics to convince people that WLS is wrong. "You'll gain it all back anyway." "You'll get all cut up and scarred for nothing."

And my point was that you don't need to come to this specific forum and tell stories about all the people in your life who have gained back weight after surgery. The procedures in place prior to surgery inform WLS candidates of this at every step of the way, which is why, coming from someone who doesn't apparently agree with or support WLS, it seems insulting.

And I, just like you, are entitled to comment. If you are insulted by that, so be it.

In general, as noted in the IF YOU HAVEN'T HAD SURGERY thread, comments like 'everyone I know has regained' aren't helpful. Althought several comments were deleted [not sure you can see them], I left Lakilaulea's post in for several reasons -

1. she's had poor outcomes with her lipo and other cosmetic procedures, so she knows that any surgery is a risk and may not work the way you want
2. she knows people who have failed WLS because they didn't change their habits, but also knows people who are doing very well because they have changed.

I almost deleted it, but for these reasons, I allowed it to stay. Having said that, please understand that this is the SUPPORT forum - so that OP's original Q was NOT about 'ooooh can i keep off this weight' but more about 'what happens later, if i decide to have the surgery - does the supervised diet start all over again.' therefore, responses that don't address that are OT.

If anyone wants to debate surgery - there are other areas of 3FC that are more appropriate. But for this particular area, we ask that the discussion keeps to SUPPORT and not pointing out what someone's friends and family have done or not done after surgery.

__________________Start your day with a smile, and get it over with.Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

WOW! I didn't realize this would start disagreements! Sorry about that.

Yes I am questioning timing. I realize some of my questions shouldbe directed towards my insurance company. But I also worry about them having "too much information" if you know what I mean. Although the fact that the insurance maked their decision off yor original starting weight and co-morbidites is good to know, I wondered how that worked.

I know with or without surgery in order to keep the weight off I have to make lifestyle changes. I think I am wondering if the risks of surgery are worth the 'reward'. If I can continue losing weight with diet and not surgery. IF I can maintain my weigt loss.

I wnder if I am trading the "misery" of being fat for the "misery" of living with surgery. maybe it isn't a "misery". But I have read about several complications, dumping syndrom, no liquids with meals etc. I know now that with the plan I am following if there is dessert offered for example I can have a bite or two of hubby's. I am not over my calorie allowment for the day, I do not get physically sick. that may not be the case after surgery. I really enjoy baked potatoes with salt and peper, I don't use butter or sour cram and I can plan those into my daily meal plan. I won't be able to do that for at least a year after surgery. Is that a change I wan't to make?

I know I am the only one that can answer these questions for myself. maybe I am venting, or thinking out loud, so to speak.

I do know that once I have the surgery that will be my new realityand I want to make sure I am making the right choice.

its a permanent thing for sure (unless you have lapband) so best to make sure I think. Other thing is that you may get to a low weight out of the surgical range. I know above someone said that they base their decision on initial consult but I cant imagine any surgeon doing a bypass on someone who was formerly in the BMI range with other illnesses months early but at surgery time needs to lose like 30 lbs. Cause even it you were eligable at one point its whats going on at surgery time that counts for the surgeon I think. xoxoxoxox

Kate - you're thinking about all the right questions and voicing all the right concerns. It's all about choosing the way each of us can live, happy and healthy, with our weight management plan and the food we eat.

Misery of being fat vs misery of living with surgery? hmmm. interesting concept. I was seeing it more as seeking the path to weight control that works for you - viewing your life and choices as causing 'misery' sort of sets a person up for unhappiness. i think. maybe.

Seems to me that finally having something that works could be actually a joyous event. at least on some levels.

__________________Start your day with a smile, and get it over with.Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

its a permanent thing for sure (unless you have lapband) so best to make sure I think. Other thing is that you may get to a low weight out of the surgical range. I know above someone said that they base their decision on initial consult but I cant imagine any surgeon doing a bypass on someone who was formerly in the BMI range with other illnesses months early but at surgery time needs to lose like 30 lbs. Cause even it you were eligable at one point its whats going on at surgery time that counts for the surgeon I think. xoxoxoxox

I would argue that even a lapband can be permanent, if you are one of the unlucky who developed scar tissues/complications from it.

And, I am also curious about losing too much weight prior to surgery as well. I just know that my surgical team/insurance confirmed (and I have read many similar stories from others online) that it was my starting weight and comorbidities that mattered, not what it was at the time of surgery. I think one of the reasons for that is insurance companies do recognize that regain for most MO and SMO people is very high.

Some surgeons, in particular in the UK I believe, are performing WLS on those who don't have weight to lose (ie-normal folks) but are diabetic, since it is well-known that WLS can significantly help those with diabetes. I find that really interesting.

I know with or without surgery in order to keep the weight off I have to make lifestyle changes. I think I am wondering if the risks of surgery are worth the 'reward'. If I can continue losing weight with diet and not surgery. IF I can maintain my weigt loss.

I wnder if I am trading the "misery" of being fat for the "misery" of living with surgery. maybe it isn't a "misery". But I have read about several complications, dumping syndrom, no liquids with meals etc. I know now that with the plan I am following if there is dessert offered for example I can have a bite or two of hubby's. I am not over my calorie allowment for the day, I do not get physically sick. that may not be the case after surgery. I really enjoy baked potatoes with salt and peper, I don't use butter or sour cram and I can plan those into my daily meal plan. I won't be able to do that for at least a year after surgery. Is that a change I wan't to make?

Interesting thoughts, Kate. I was really worried about the "reward" aspect as well prior to surgery, in that would the weight loss really be worth the sacrifices? There definitely can be complications from the surgery (and in my first six months, I had a few). I actually wish I had dumping syndrome now, believe it or not. Only about 30% of postops suffer from it; I was hoping to be in that % as I wanted something to help me stay away from sweets. No such luck, lol.

I never thought, though, that sticking to the requirements would be a misery. In actuality (other than drinking with meals), how we are to eat is how I wish I could have eaten without the surgery. I know I lose and feel better with limited carbs and sugar, but I couldn't stick to it preop because of the insatiable hunger and desire for them. Since I don't get ravenously hungry any more, it is much easier to follow the rules. In no way would I call the lifestyle changes miserable. But again, that is my own point of view and outlook.

Yes Kate you will want to make that change. I won't speak for anyone but myself but it wasn't until after I had the surgery that I recognized and admitted that I was a food addict and an emotional eater, both things I would have denied to my last breath prior to surgery. You are no doubt thinking of the joy that you get from eating but there is misery there too no doubt.

When I finally got to the end of my weight loss rope there was absolutely no question in my head about having the surgery, none at all. I might have thought for about 1 minute about not having it and continuing to struggle to lose weight on my own but I KNOW without a doubt I could never have done what I have done so far. That you have lost as much as I have without surgery to me says a great deal about how well you are doing all of this. You are learning coping mechanisms that I never could have done (and still somewhat have not managed). I do not know how your insurance company and all that works where you are but it doesn't feel to me that you are yet at the end of your rope. If you do change your mind and have to wait another 6 months it won't be a huge setback because you already know you can lose weight without surgery. I didn't know that because I had struggled all my life and things were just getting worse.